Can you take Acetaminophen / dextromethorphan / guaifenesin / pseudoephedrine with Sibutramine?

The acetaminophen in acetaminophen / dextromethorphan / guaifenesin / pseudoephedrine has a major potential interaction with Alcoholism.

Chronic alcohol abusers may be at increased risk of hepatotoxicity during treatment with acetaminophen (APAP). Severe liver injury, including cases of acute liver failure resulting in liver transplant and death, has been reported in patients using acetaminophen. Therapy with acetaminophen should be administered cautiously, if at all, in patients who consume three or more alcoholic drinks a day. In general, patients should avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure. They should also be advised to seek medical attention if they experience signs and symptoms of liver injury such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice.

Sibutramine has a moderate potential interaction with Alcoholism.

Centrally-acting anorexiants are generally subject to habituation and abuse. While sibutramine does not appear to have a significant potential for abuse, clinical data are limited. Therapy with sibutramine should be administered cautiously in patients with a history of alcohol or substance abuse. Such patients should be observed carefully during therapy for signs of misuse of sibutramine.

Sibutramine has a major potential interaction with Anorexia Nervosa.

The use of sibutramine is contraindicated in patients with anorexia nervosa. Sibutramine is an anorexiant used in the treatment of obesity.

The pseudoephedrine in acetaminophen / dextromethorphan / guaifenesin / pseudoephedrine has a moderate potential interaction with Benign Prostatic Hyperplasia.

Sympathomimetic agents may cause or worsen urinary difficulty in patients with prostate enlargement due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with sympathomimetic agents should be administered cautiously in patients with hypertrophy or neoplasm of the prostate.

The pseudoephedrine in acetaminophen / dextromethorphan / guaifenesin / pseudoephedrine has a major potential interaction with Cardiovascular Conditions and Disorders.

Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.

Sibutramine has a major potential interaction with Cardiovascular Conditions and Disorders.

Sibutramine and its metabolites inhibit the reuptake of norepinephrine, serotonin, and dopamine and can induce substantial increases in heart rate and blood pressure in some patients. Sibutramine therapy should not be initiated in patients with uncontrolled or poorly controlled hypertension and/or a history of coronary artery disease, arrhythmias, congestive heart failure, stroke, or other severe cardiovascular or cerebrovascular disorders. All patients treated with sibutramine should have blood pressure and pulse measured prior to starting therapy and monitored at regular intervals thereafter. Sustained increases in blood pressure or pulse rate may require a dosage reduction or drug discontinuation.

Sibutramine has a major potential interaction with Cerebral Vascular Disorder.

Sibutramine and its metabolites inhibit the reuptake of norepinephrine, serotonin, and dopamine and can induce substantial increases in heart rate and blood pressure in some patients. Sibutramine therapy should not be initiated in patients with uncontrolled or poorly controlled hypertension and/or a history of coronary artery disease, arrhythmias, congestive heart failure, stroke, or other severe cardiovascular or cerebrovascular disorders. All patients treated with sibutramine should have blood pressure and pulse measured prior to starting therapy and monitored at regular intervals thereafter. Sustained increases in blood pressure or pulse rate may require a dosage reduction or drug discontinuation.

The pseudoephedrine in acetaminophen / dextromethorphan / guaifenesin / pseudoephedrine has a major potential interaction with Cerebrovascular Insufficiency.

Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.

The acetaminophen in acetaminophen / dextromethorphan / guaifenesin / pseudoephedrine has a major potential interaction with Dehydration.

Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.

The pseudoephedrine in acetaminophen / dextromethorphan / guaifenesin / pseudoephedrine has a moderate potential interaction with Diabetes Mellitus.

Sympathomimetic agents may cause increases in blood glucose concentrations. These effects are usually transient and slight but may be significant with dosages higher than those normally recommended. Therapy with sympathomimetic agents should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate.

Sibutramine has a moderate potential interaction with Drug Dependence.

Centrally-acting anorexiants are generally subject to habituation and abuse. While sibutramine does not appear to have a significant potential for abuse, clinical data are limited. Therapy with sibutramine should be administered cautiously in patients with a history of alcohol or substance abuse. Such patients should be observed carefully during therapy for signs of misuse of sibutramine.

The pseudoephedrine in acetaminophen / dextromethorphan / guaifenesin / pseudoephedrine has a moderate potential interaction with Gastrointestinal Obstruction.

The extended-release formulation of pseudoephedrine (Sudafed 24 Hour) contains a non-deformable material. There have been rare reports of obstructive symptoms in patients with known strictures following the ingestion of similar sustained-release products. Therapy with the extended-release formulation of pseudoephedrine should be administered cautiously in patients with preexisting severe gastrointestinal narrowing or obstruction, whether pathologic or iatrogenic.

Sibutramine has a major potential interaction with Glaucoma, Narrow Angle.

Sibutramine and its metabolites inhibit the reuptake of norepinephrine, serotonin, and dopamine and can induce mydriasis. In patients with narrow angles, pupillary dilation can provoke an acute attack of angle-closure glaucoma. Therapy with sibutramine should be administered cautiously in patients with narrow-angle glaucoma or anatomically narrow angles.

The pseudoephedrine in acetaminophen / dextromethorphan / guaifenesin / pseudoephedrine has a moderate potential interaction with Glaucoma/Intraocular Hypertension.

Sympathomimetic agents can induce transient mydriasis via stimulation of alpha-1 adrenergic receptors. In patients with anatomically narrow angles or narrow-angle glaucoma, pupillary dilation can provoke an acute attack. In patients with other forms of glaucoma, mydriasis may occasionally increase intraocular pressure. Therapy with sympathomimetic agents should be administered cautiously in patients with or predisposed to glaucoma, particularly narrow-angle glaucoma.

Sibutramine has a major potential interaction with History, Thrombotic/Thromboembolic Disorder.

Sibutramine and its metabolites inhibit the reuptake of norepinephrine, serotonin, and dopamine and can induce substantial increases in heart rate and blood pressure in some patients. Sibutramine therapy should not be initiated in patients with uncontrolled or poorly controlled hypertension and/or a history of coronary artery disease, arrhythmias, congestive heart failure, stroke, or other severe cardiovascular or cerebrovascular disorders. All patients treated with sibutramine should have blood pressure and pulse measured prior to starting therapy and monitored at regular intervals thereafter. Sustained increases in blood pressure or pulse rate may require a dosage reduction or drug discontinuation.

Sibutramine has a major potential interaction with History - Cerebrovascular Disease.

Sibutramine and its metabolites inhibit the reuptake of norepinephrine, serotonin, and dopamine and can induce substantial increases in heart rate and blood pressure in some patients. Sibutramine therapy should not be initiated in patients with uncontrolled or poorly controlled hypertension and/or a history of coronary artery disease, arrhythmias, congestive heart failure, stroke, or other severe cardiovascular or cerebrovascular disorders. All patients treated with sibutramine should have blood pressure and pulse measured prior to starting therapy and monitored at regular intervals thereafter. Sustained increases in blood pressure or pulse rate may require a dosage reduction or drug discontinuation.

Sibutramine has a major potential interaction with History - Myocardial Infarction.

Sibutramine and its metabolites inhibit the reuptake of norepinephrine, serotonin, and dopamine and can induce substantial increases in heart rate and blood pressure in some patients. Sibutramine therapy should not be initiated in patients with uncontrolled or poorly controlled hypertension and/or a history of coronary artery disease, arrhythmias, congestive heart failure, stroke, or other severe cardiovascular or cerebrovascular disorders. All patients treated with sibutramine should have blood pressure and pulse measured prior to starting therapy and monitored at regular intervals thereafter. Sustained increases in blood pressure or pulse rate may require a dosage reduction or drug discontinuation.

The pseudoephedrine in acetaminophen / dextromethorphan / guaifenesin / pseudoephedrine has a major potential interaction with Hyperthyroidism.

Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.

The acetaminophen in acetaminophen / dextromethorphan / guaifenesin / pseudoephedrine has a major potential interaction with Liver Disease.

Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.

Sibutramine has a major potential interaction with Liver Disease.

Sibutramine is converted by the liver to two active metabolites, which are further metabolized to inactive substances and subsequently eliminated by the kidney. Due to a lack of clinical data, the manufacturer does not recommend the use of sibutramine in patients with severe renal and/or hepatic impairment. Based on limited pharmacokinetic data, sibutramine may be administered in mild or moderate hepatic insufficiency at normally recommended dosages.

The acetaminophen in acetaminophen / dextromethorphan / guaifenesin / pseudoephedrine has a major potential interaction with Malnourishment.

Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.

The acetaminophen in acetaminophen / dextromethorphan / guaifenesin / pseudoephedrine has a moderate potential interaction with Phenylketonuria.

Several oral acetaminophen and acetaminophen-combination products, particularly flavored chewable tablets, contain the artificial sweetener, aspartame (NutraSweet). Aspartame is converted to phenylalanine in the gastrointestinal tract following ingestion. Chewable and effervescent formulations of acetaminophen products may also contain phenylalanine. The aspartame/phenylalanine content should be considered when these products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).

The pseudoephedrine in acetaminophen / dextromethorphan / guaifenesin / pseudoephedrine has a moderate potential interaction with Phenylketonuria.

Chewable products frequently may contain aspartame, which is metabolized in the gastrointestinal tract to phenylalanine. Sudafed (brand of pseudoephedrine) chewable 15 mg tablets provide the equivalent of 0.78 mg of phenylalanine per each tablet. The aspartame/phenylalanine content should be considered when this and similar products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).

The pseudoephedrine in acetaminophen / dextromethorphan / guaifenesin / pseudoephedrine has a major potential interaction with Pheochromocytoma.

Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.

The pseudoephedrine in acetaminophen / dextromethorphan / guaifenesin / pseudoephedrine has a moderate potential interaction with Prostate Tumor, Benign.

Sympathomimetic agents may cause or worsen urinary difficulty in patients with prostate enlargement due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with sympathomimetic agents should be administered cautiously in patients with hypertrophy or neoplasm of the prostate.

Sibutramine has a major potential interaction with Renal Dysfunction.

Sibutramine is converted by the liver to two active metabolites, which are further metabolized to inactive substances and subsequently eliminated by the kidney. Due to a lack of clinical data, the manufacturer does not recommend the use of sibutramine in patients with severe renal and/or hepatic impairment. Based on limited pharmacokinetic data, sibutramine may be administered in mild or moderate hepatic insufficiency at normally recommended dosages.

Sibutramine has a moderate potential interaction with Seizures.

Sibutramine and its metabolites inhibit the reuptake of norepinephrine, serotonin, and dopamine. In clinical trials, seizures were reported in < 0.1% of patients treated with sibutramine. Therapy with sibutramine should be administered cautiously in patients with or predisposed to seizures.

Sibutramine has a moderate potential interaction with Type 2 Diabetes.

Obese, type 2 diabetic patients who achieve weight loss may demonstrate improved metabolic control of their disease as a result of their reduced weight. Therefore, patients with type 2 diabetes mellitus should be monitored during weight-reduction therapy (or therapy that may be expected to induce significant weight loss as a secondary effect) for hypoglycemia and reduced need for oral hypoglycemic medication or insulin, and the dosages of these agents adjusted accordingly. Patients should be apprised of the risk of hypoglycemia and be alert to potential signs and symptoms such as headache, dizziness, drowsiness, nervousness, confusion, tremor, hunger, weakness, perspiration, and palpitation.